Flashcards in Procedures Test 2- spine procedures Deck (74)
What 2 joints will be open on a Lateral C-spine?
Zygapophyseal and intervertebral disk spaces
What is the SID for the lateral and oblique C-Spine? Why?
72 inches to compensate for increased OID
When do you do a swimmers projection?
When C7/T1 is NOT well demonstrated on a lateral c-spine
Before doing lateral hyperflexion/hyperextension C-spine what must be ruled out?
Fractures and pathology
Hyperflexion and hyperextension C-spine views are used to demonstrate what?
Used to demonstrate absence of normal movement from trauma or disease and range of motion
What type of breathing is used for the swimmers method?
Breathing technique or suspend
What will you have the patient do during the odontoid projection to get the tounge out of the way?
Have the patient say "ah"
If the dens is not well demonstrated on the open mouth projection what view can be done to better show the dens?(2 answers)
AP and PA dens
When doing the Judd method of the Dens if the OML should be how many degrees to the plane of the IR?
AP axial oblique projections of the C-spine demonstrate which intervertebral foramen?
PA axial oblique projections of the c-spine which intervertebral foramina are demonstrated?
When doing the cervical spine obliques how much is the patient rotated?
The lateral t spine best demonstrates what?
Intervertebral disc spaces and intervertebral foramina
T3 and L1
What is the best type of respiration used for the spine images?
Breathing technique or suspend
The lateral C spine shows what in profile?
Spinous processes, intervertebral discs, vertebral bodies, and zygapophyseal
How many vertebra should you see on the AP axial c spine image?
What intervertebral disc space should be seen on the swimmers?
What joint do you see on the AP open mouth odontoid?
You will see the dens inside the foramen magnum on which projections? (2 answers)
Fuchs and Judd
What two pieces of anatomy are you going to line up and make perpendicular to the IR when doing an open mouth odontoid?
Tip of upper incisors and mastoid tip
Where will the CR enter for C spine projections?
What is the tube angle for the AP axial c spine?
What is the tube angle for the AP oblique c spine? ( RPO/LPO)
What is the tube angle for the PA oblique c spine? (RAO/LAO)
What is the tube angle for the swimmers method?
Where will the CR enter for the swimmers method?
Where does the CR better for the patient for the Fuchs method?
MSP- distal to chin tip
Where does the CR enter the patient for the Judd method?
MSP- distal to level of mastoid tips
Where does the CR enter the patient for the open mouth odontoid?
Midpoint of the open mouth
By instructing the patient to open their mouth for the AP open mouth odontoid what anatomy are you getting out of the way?
Tounge and teeth
Obliques of the c-spine (know how to determine what oblique you are looking at based off of the image)
Uses markers. If bodies are between it and the foramina
Where does the CR enter for the T spine projections?
How many vertebra will you see?
All 12 vertebra
Why is it important to have the patient flex their hips and knees when doing the AP lumbar spine?
Reduces lordotic curve. Places lower back closer to the table reducing OID
What's the position for swimmers?
One closest to IR arm is up, arm is down furthest from IR
Which view of the L spine demonstrates the intervertebral foramina?
Lateral L spine
Which obliques demonstrate the RIGHT zygapophyseal joints in the lumbar spine?
RPO and LAO
Which obliques demonstrate the LEFT zygapophyseal joints in the lumbar spine?
RAO & LPO
How much do you rotate the patient when doing oblique L-spine projections?
Know the Scotty dog
Ear- superior articular process
Neck- pars interactalis
Leg-inferior articular process
The RPO of the SI joints demonstrates the joint _____ from the IR.
So RPO SI joints demonstrates
The LPO SI joint demonstrates
The RAO/LAO of the SI joints demonstrates the joint ____ to the IR
How much do you rotate the patient when doing oblique SI joints?
When doing the lateral sacrum what plane needs to be perpendicular to the IR?
Inter iliac plane or line
Be Able to describe how to do both images of the scoliosis PA AP Ferguson
First image 1 inch above the crest MSP to midline of grid, arms abducted.
Second image- same position but this time elevate the patients hip on the side of primary curve approximately three or four more inches
The lateral L spine flexion and extension is used to demonstrate what?
Spinal fusion or disc hernination
The lateral l spine flexion and extension positions
1st image- fetal position flexing spine as much as possible
2nd image- arch posterior extending their spine
CR of lateral L spine flexion and extension
Spinal fusion or L3-crest
The right and left bending L spine projections are used to determine or localize what?
Early scoliosis to determine structural change. Localize herniated disc and determine if there is motion in the region of spinal fusion
CR of right and left bending L spine projections
1-1 1/2 above iliac crest L3 MSP
Right and left bending L spine projections positions
Bend as much as possible to whatever side and cross opposite leg do not rotate pelvis
If the spine is not horizontal to the table for the lateral L spine what positioning tool might you use to adjust this?
Sponge or other radiolucent support
Why is it good to put a small piece of lead behind the patient when doing lateral images of the spine?
Angle for male L5-s1
Angle for female L5-S1
Which projection will demonstrate the L5-S1 joint open in an AP L spine? What else does this projection demonstrate?
Ferguson method/ AP axial L5-S1
Both SI joints
Where does the CR enter the patient for an AP L-spine?
More sacrum- L4 crest MSP
Less sacrum 1 1/2 inches above crest (L3) MSP
Where does the CR enter for the lateral L-spine?
MCP at crests (L4)
What is the CR for the lateral L5-S1 spot?
1 1/2 inches below the iliac crest and 2 inches posterior the coronal plane at level of ASIS
What is the CR for AP oblique L spines?
RPO/LPO 1 1/2 inches above crest(L3) and 2 inches medial to ASIS
What is the CR for PA obliques L spine?
RAO/LAO 1- 1 1/2 inches above iliac crest and enters elevated side approximately 2 inches to lateral spinous process
How much do you angle for the AP Axial L5-S1 joints?
30-35 more on females less on males
What is the CR for AP axial L5-S1 joints?
1 1/2 inches above pubic symphysis MSP
What is the CR for oblique SI joints?
1 inch medial to elevated ASIS
What does the lateral L spine shows in profile?
Vertebral bodies, spinous process, intervertebral disc spaces, intervertebral foramina in profile
What is the angle for AP sacrum?
What is the angle for AP coccyx?
What is the CR for AP sacrum?
2 inches superior to pubic symphysis MSP
What is the CR for AP coccyx?
2 inches superior to Punic symphysis MSP
What is the CR for lateral sacrum?
Level of ASIS and to a point 3 1/2 inches posterior
What is the CR for the lateral coccyx?
2 inches distal ASIS to a point 3 1/2 inches posterior